Ein effektives, multimodales Therapiekonzept zur Behandlung des peritoneal metastasierten Ovarialkarzinom-Rezidivs

Abstract

Optimal treatment of chemoresistant and recurrent ovarian cancer is debating with second line chemotherapies. For peritoneal carcinomatosis new treatment combining cytoreductive surgery with heated intraperitoneal perioperative chemotherapy (HIPEC) may improve survival. METHODS: Retrospective analysis of 70 patients with peritoneal carcinomatosis from ovarian cancer were performed to evaluate feasibility of second debulking plus hyperthermic peritoneal perfusion (HIPEC) and to identify prognostic factors. HIPEC is performed with Mitomycin (20 mg/m 2 ) plus Mitoxantron (20 mg/m 2 ) at 41.5 °C. RESULTS: The study included 78 procedures in 70 patients from 4/2002 to 5/2006. Rate for complete resection (CC-0 + 1 resection) was 81 %. Procedure relates morbidity was 20.5 % without postoperative mortality. Two year survival rate was 72 %. Independent prognostic factors for survival were the extent of carcinomatosis, the completeness of cytoreduction and performance status. CONCLUSIONS: HIPEC is a standardized and reproducible feasible method. Less extensive disease and the quality of cytoreduction remain an independent factor of better outcome. Morbidity is acceptable. In selected patients HIPEC allows to reach the longest median time survival in recurrent peritoneal carcinomatosis from ovarian cancer.